Christmas Meal Booking Form
By completing this form you are CONFIRMING A RESERVATION REQUEST FOR YOUR CHRISTMAS MEAL at the Leopold Brasserie Brussels EU

PLEASE COMPLETE ALL COMPULSORY SECTIONS

You need to select the number of people. We take a 10 EUR non-refundable deposit immediately and you pay the rest by 7th December 2018

For MORE THAN 6 people you need to contact us for a price

PLEASE CLICK SUBMIT AT THE BOTTOM when finished

THIS FORM SECURELY PROTECTS YOUR DATA

Email address *
For any further information send an email to reservations@hotel-leopold.be OR chat with us on messenger m.me/LeopoldHotelBrusselsEU
Christmas Lunch or Dinner @ 39 EUR per person. Drinks not included - click here for the Menu http://slink.be/172
Your Name & Family Name *
Your answer
Your Telephone Number *
Your answer
Your Address (street/town/postcode/country) *
Your answer
Your Credit Card number (in the form xxxx xxxx xxxx xxxx) *
Your answer
Your Credit Card expiry (in the form xx/xx) *
Your answer
Your Credit Card cvc (in the form xxx) *
Your answer
Number of people (click on your choice) *
Date of meal (select 1) *
Time of meal (select 1) *
I agree that you deduct 10 eur from my credit card as a non-refundable deposit *
Required
Confirmation - We will contact you by return with a confirmation number and pro forma invoice for the final payment which will be due on Friday 7th December
Our terms and conditions *
Required
Our Privacy Statement *
Required
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